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Question to anyone: Do you think strenuous exercise can cause a relapse?

I ask this because exercise is so pushed as nothing but a positive for us MS'ers and I have taken that to heart. In the last five years I have barely missed a day of running except this winter during a bad time and horrible weather around here. Since I've started back, I feel like I can barely finish my runs. I start OK, but by the end I can still run from an in shape, cardio point of view, but I can barely stay standing until I cool off and also from feeling weak kneed.

Now I know all the stuff about heat and MS, but up until this year the only thing that would be adversely affected during a run was my eyes. Now they are big time and I get all tingly up my legs and the balance is absolutely shot.

I am very in tune to keeping a watch out for a relapse since I'm in the Tovaxin trial. I guess I want someone who may know more about this than most since I can't find anything except exercise, exercise, exercise in all my MS "stuff".

Since I know I have the Uthoff's sign when it comes to my ON, maybe it's just underlying damage coming to the surface with the heat like with my eyes, but it's just very hard to try and cut back since this helps me so much with strength and self esteem (not to mention my bowels). Could I possibly just need to cut back? Like maybe I'm pushing too hard?

I would relish any input.

Lew

I wouldn't say that strenuous exercise causes relapses but I don't think that it's a good idea to overdo anything. In my case when I have overdone exercise I end up re-activating old symptoms. I just try to do everything in moderation now. It such a double edged sword isn't it. It's supposed to help but too much can hurt.

I think you are right....cut back just a bit. Take your time and try not to get overheated. I work out about 1 1/2 hours a day....weight training and 30 minutes cardio. I have to have a fan pointing directly on me or I'm toast at the end of my workout. Take care and good luck!

Thanks for the input. I did an experiment on myself last night (it involved sleeping on a towel ). I've had 3 episodes of nighttime incontinence in the last month (these are my first three). All three have been on nights when I have run that evening. Also, when I wake up and notice it, my legs are very numb, but I think it's from not moving. All three times I have awakened in the exact same position I fell asleep in; on my back. It feels like my butt has fallen asleep like when you are sitting in a hard chair for a long time and when I get up it goes away so I know the numbness is more circulation driven than MS. Maybe the MS is making it worse, but I wouldn't imagine it would go away upon standing if the numbness was solely from the MS.

I'm going to try and cut back and see if that goes away. It's just so damn hard to give things up. I'm really just starting to have to deal with that.

Hi Lew,
Obviously you're already aware that in the past Uhthoff's phenomenon was used as a diagnostic tool.

It might not be accurate to say that overexcertion can bring on a relapse but part of the reason they quit using Uhthoff's as a diagnostic tool is because they found that the symptoms sometimes don't completely dissapear.

I've never read anything which would give an idea how common it would be that a person's symptoms don't go away after overexertion/overheating though. I have read that it's more important to stay fit than to worry about Uhthoff's and that swimming is a good way to exercise without overheating.

Plus, when the time comes you can just pee in the pool like I do........um, I mean like some people do.

Bob

Ha! Hey, fish do it....Anyway, I plan on really spending a lot of time in the pool this season. Our daughter is on the swim team and we are at the pool all the time. I'm a life long swimmer myself, but since I got out of swim team at the age of 18 I pretty much have used the pool to relax.

I think my body is telling me to change what I'm doing and I'm not listening. I am having such difficulty running that I should really reconsider that as my method of exercise. I get so herky jerky after I get hot that it is also starting to hurt my knees and hips.

Giving up the Superman complex is a hell of a lot harder than I thought it would be. That sounds a bit facetious, but I'm serious. I have been used to being everything on all fronts (including physical) for my family and right now, I'm not doing well with what I'm having to give up.

Thank you guys for your input. You people save me a ton of money on therapy bills!

Lyon wrote: I've never read anything which would give an idea how common it would be that a person's symptoms don't go away after overexertion/overheating though. I have read that it's more important to stay fit than to worry about Uhthoff's and that swimming is a good way to exercise without overheating.

Overexertion could bring the relapse. If you experience transitory symptoms appearance during or right after exercises you must know that you are at the edge. Cut it down at once. Golden rule – you must feel yourself better but not worse after you did some workout.
I am against running for many reasons; maybe I’ll post about it one time. The best physical activity for MS – swimming in moderation. Even ‘walking’ in the water is good. Please take care of the water temperature, it is individual thing, but it must never provoke any, even slight, discomfort or symptoms worsening.
Instead of running use a treadmill - less harmful, more benefits. Another golden rule for MS – do everything on a slower side.

For your information Bob, if symptoms stay for more than 6 hours, treatment could be considered to halt/reverse the very beginning of starting relapse.

Kind regards,
Tony

Hi Tony,
Just to be sure, you're saying that ovedoing exercise could speed disability progression?
Bob

I don't mean to butt in but I have read that a temporary worsening of your symptoms can be caused by overheating, as in exercise. This condition usually disappears after you return to normal temperature. The National MS website calls it a "pseudoexacerbation." They state that it does not cause your MS to progress. Every ones tolerance to heat will be different. I still lift weights intensely usually four times a week. I get a good sweat going and so far so good. Right after I was dx (May 2004) I tried to run in the heat and it really wiped me out. After that, any running I do is when the temp. and my symptoms allow it.
Terry

I also don't mean to butt in...but, this has been a quandary of mine as well...do i exercise and how much?...I think one of the most difficult aspects of this is that ultimately, we really don't know...I used to be a pretty active guy in sports and haven't been active since my attack (2 1/2 years ago)...i've tried to get back into things b y going on slow and long walks, but have noticed that my left arm is usually numb by the end of it all...

At this juncture, my thought is like others...that consistent and moderate exercise is probably best...with an emphasis on activities that don't heat up the CNS as much as possible...

just my two cents,

TOL

Hi Bob,
Yes, overdoing exercise could speed disability progression.
Increase of the heat (inside the body) during exercises is a natural part of body reaction, not so much we can do with that. Normal fluctuation of body’s temperature is ok for MS, extensive heat is not. I recommend staying inside if temperature is more than 85, or take the necessary precautions. Dress lightly, use cold drinks, exercise in colder water (with body immersed) and you will be fine.
Bigger problem is pain (muscles, ligaments, joints) and forced joints damage if you have even unnoticeable (visually) degree of spasticity. This triggers MS more.
Moderation is the key, and slower temp is important also. Pay attention for ‘recovery’ if you experience any kind of discomfort after exercises, analyze and bring them down.

Kind regards,
Tony

Tony,

Could I ask you to elaborate a little more on the pain and joint part of your post? This has been part of my new stuff as well, a lot of joint stiffness and pain that I had never experienced before. By elaborate I mean would this be an indication of a relapse?

Lew

There's no way exercise can cause a relapse/speed disability. It's not logical (not to say much related to MS is logical, but I digress). Many different variables increase body temperature (including interferons).

Working out is the most proactive treatment, and the only one we can control. Inaction leads to nothing.

Loobie wrote:
Could I ask you to elaborate a little more on the pain and joint part of your post? This has been part of my new stuff as well, a lot of joint stiffness and pain that I had never experienced before. By elaborate I mean would this be an indication of a relapse?

Not necessarily.
Probably you got the beginning of deformative arthrosis which always follows the spasticity.
Explanation is pretty simple; because of changes of muscles tonus and ligaments tonus in extremities (doesn’t matter legs or arms) the locomotion/movements became different. It alters proper joints configuration and ‘wear and tear’ of joints increase remarkably. In severe spasticity cases you can get hips arthrosis in couple of years. If you load these joints even with moderate exercises (as running, for ex.) you will have this kind of complication much sooner. The same is valid for fatigue when decrease of muscle tonus leads to change of joints configuration as well.
Treatment of this problem is not as effective as you see on TV ads, Advil alone is not enough.
Increased joints pain will increase the level of spasticity; in this case it is real vicious cycle.
In other words you will have decline in your status not only because of MS itself, but from complication of spasticity.
Pain is a major stressful factor in our life. Stress itself is the one of the MS exacerbation triggers. In case of chronic pain you will fell into chronic stress, which is even worse.
Therefore be careful when choosing what kind of exercises to do.
European advanced MS Societies have specially trained kinesiologists who understands MS and provide patients with individually tailored program. Check for such service in your local branch.

Kind regards,
Tony

I didn't doubt you Tony but I had to look it up and figured I'd save the others from the effort. Bob

Definition of Arthrosis

Arthrosis: An arthrosis is a joint, an area where two bones are attached for the purpose of motion of body parts. An arthrosis (joint) is usually formed of fibrous connective tissue and cartilage.

Joints are grouped according to their motion: a ball and socket joint; a hinge joint; a condyloid joint (a joint that permits all forms of angular movement except axial rotation); a pivot joint; gliding joint; and a saddle joint.

Joints can move in four and only four ways:

* Gliding -- one bony surface glides on another without angular or rotatory movement;
* Angular -- occurs only between long bones, increasing or decreasing the angle between the bones;
* Circumduction -- occurs in joints composed of the head of a bone and an articular cavity, the long bone describing a series of circles, the whole forming a cone; and
* Rotation -- a bone moves about a central axis without moving from this axis.

The word "arthrosis" comes from a Greek root, "arthros" meaning a joint (as in arthritis, inflammation of a joint). The word "joint" itself comes from a Latin root, "junctio" meaning a joining (as in a junction).